Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;51(6):821-828.
doi: 10.1111/cea.13867. Epub 2021 Apr 2.

@IT2020: An innovative algorithm for allergen immunotherapy prescription in seasonal allergic rhinitis

Stefania Arasi  1   2   3 , Sveva Castelli  2 , Marco Di Fraia  2 , Danilo Villalta  4 , Salvatore Tripodi  5 , Serena Perna  2 , Stephanie Dramburg  2 , Maria Antonia Brighetti  6 , Mariaelisabetta Conte  4 , Paola Martelli  4 , Ifigenia Sfika  5 , Alessandro Travaglini  6 , Pier Luigi Verardo  7 , Valeria Villella  5 , Paolo Maria Matricardi  2
Affiliations

@IT2020: An innovative algorithm for allergen immunotherapy prescription in seasonal allergic rhinitis

Stefania Arasi et al. Clin Exp Allergy. 2021 Jun.

Abstract

Background: Allergen immunotherapy (AIT) is the only disease-modifying treatment in patients with seasonal allergic rhinoconjunctivitis (SAR). Its efficacy depends on the precise identification of the triggering allergen. However, diagnostics based on retrospective clinical history and sensitization to whole extracts (SWE) often leads to equivocal results.

Objectives: To assess the usability and impact of a recently established algorithm for a clinical decision support system (@IT2020-CDSS) for SAR and its diagnostic steps [anamnesis, SWE (skin prick test or serum IgE), component resolved diagnosis, CRD, and real-time digital symptom recording, eDiary] on doctor's AIT prescription decisions.

Methods: After educational training on the @IT2020-CDSS algorithm, 46 doctors (18 allergy specialists, AS, and 28 general practitioners, GP) expressed their hypothetical AIT prescription for 10 clinical index cases. Decisions were recorded repeatedly based on different steps of the algorithm. The usability and perceived impact of the algorithm were evaluated.

Results: The combined use of CRD and an eDiary increased the hypothetical AIT prescriptions, both among AS and GP (p < .01). AIT prescription for pollen and Alternaria allergy based on anamnesis and SWE was heterogeneous but converged towards a consensus by integrating CRD and eDiary information. Doctors considered the algorithm useful and recognized its potential in enhancing traditional diagnostics.

Conclusions and clinical implications: The implementation of CRD and eDiary in the @IT2020-CDSS algorithm improved consensus on AIT prescription for SAR among AS and GP. The potential usefulness of a CDSS for aetiological diagnosis of SAR and AIT prescription in real-world clinical practice deserves further investigation.

Keywords: allergen-specific immunotherapy; clinical decision support system; component resolved diagnostics; mobile health; seasonal allergic rhinitis.

PubMed Disclaimer

Comment in

References

REFERENCES

    1. Asher MI, Montefort S, Björkstén B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006;368:733-743.
    1. Roberts G, Pfaar O, Akdis CA, et al. EAACI guidelines on allergen immunotherapy: allergic rhinoconjunctivitis. Allergy. 2018;73(4):765-798.
    1. Dhami S, Nurmatov U, Arasi S, et al. Allergen immunotherapy for allergic rhinoconjunctivitis: a systematic review and meta-analysis. Allergy. 2017;72:1597-1631.
    1. Canonica GW, Bachert C, Hellings P, et al. Allergen immunotherapy (AIT): a prototype of precision medicine. World Allergy Organ J. 2015;10(8):31.
    1. Letrán A, Espinazo M, Moreno F. Measurement of IgE to pollen allergen components is helpful in selecting patients for immunotherapy. Ann Allergy Asthma Immunol. 2013;111:295-297.

Publication types

MeSH terms

LinkOut - more resources